Bromocriptine as primary therapy for prolactin-secreting macroadenomas: Results of a prospective multicenter study

Mark E. Molitch, Richard L. Elton, Richard E. Blackwell, Burton Caldwell, R. Jeffrey Chang, Robert Jaffe, Graham Joplin, Richard J. Robbins, John Tyson, Michael O. Thorner, R. E. Blackwell, J. J. Vitek, E. R. Duvall, L. B. Kline, R. J. Chang, L. Goodman, H. E. Carlson, R. Jaffe, E. D. Schriock, M. MartinR. J. Robbins, J. Stears, G. Joplin, R. T. Jung, J. L C Ch’ng, G. Bydder, D. H. Carr, K. Mashiter, J. Tyson, S. Reichlin, S. M. Wolpert, T. Herman, L. King, T. Hedges, M. O. Thorner, M. L. Vance, S. A. Newman, J. L. Morris, B. Caldwell, R. L. Elton, L. Boyette, J. C. Hoffman, The Bromocriptine Study Group

Research output: Contribution to journalArticle

328 Scopus citations

Abstract

To assess the effectiveness of bromocriptine in reducing the size of PRL-secreting macroadenomas with extra-sellar extension, we conducted a prospective multicenter trial inpatients without prior radiotherapy, applying a standard protocol of treatment and tumor size evaluation. Basal serum PRL levels [1441 ± 417 (±SEM) ng/ml for women; 3451 ± 1111 ng/ml for men] fell in all patients and to 11% or less of basal values in all patients but 1. Normal PRL levels were reached in 18 of the 27 patients. In 13 patients (46%), tumor size was reduced by greater than 50%, in 5 patients (18%) by about 50%, and in 9 patients (36%) by approximately 10-25%. The extent of tumor size reduction did not correlate with basal PRL, nadir PRL, percent fall in PRL, or whether PRL levels reached normal. However, a reduction in PRL levels always preceded any detectable change intumor size. In 19 patients, reduction in tumor size was evident by 6 weeks, but in the other 8, suchreduction was not noted until the 6 month evaluation. In the 4 patients in whom bromocriptine was discontinued at the end of 1 yr, tumor reexpansion occurred in 3. Visual fields improved in 9 ofhe 10 patients in whom they were abnormal. Because of the excellent results found in most of the patients n i this series, we suggest thattherapy with bromocriptine should be considered as initial management for patients with PRL-secreting macroadenomas.

Original languageEnglish (US)
Pages (from-to)698-705
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Volume60
Issue number4
DOIs
StatePublished - Apr 1985

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

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    Molitch, M. E., Elton, R. L., Blackwell, R. E., Caldwell, B., Chang, R. J., Jaffe, R., Joplin, G., Robbins, R. J., Tyson, J., Thorner, M. O., Blackwell, R. E., Vitek, J. J., Duvall, E. R., Kline, L. B., Chang, R. J., Goodman, L., Carlson, H. E., Jaffe, R., Schriock, E. D., ... The Bromocriptine Study Group (1985). Bromocriptine as primary therapy for prolactin-secreting macroadenomas: Results of a prospective multicenter study. Journal of Clinical Endocrinology and Metabolism, 60(4), 698-705. https://doi.org/10.1210/jcem-60-4-698